NPIMap

Organization Active NPI

Clay County Healthcare Authority

Doing business as Clay County Nursing Home

  • Skilled Nursing Facility
  • Ashland, AL
National Provider Identifier
1417003245
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
N1401 Issued in AL
Legal business name
CLAY COUNTY HEALTHCARE AUTHORITY
Doing business as
Clay County Nursing Home
Practice address
83825 Highway 9
Ashland, AL 36251-1270
Phone
(256) 354-1141
Fax
(256) 354-1244
NPI assigned
Jan 26, 2007
Last updated
Oct 19, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CLAY COUNTY HEALTHCARE AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Richard Stephen Young
Title
Ceo
Phone
(256) 354-2131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X N1401 AL Primary

Addresses

Primary practice location

83825 Highway 9
Ashland, AL 36251-1270

Mailing address

PO Box 1270
Ashland, AL 36251-1270
Phone (256) 354-1141

Other identifiers 2

IdentifierTypeStateIssuer
01505OtherALBCBS PROVIDER NUMBER
475333OSMedicaidAL

Other names 1

  • Clay County Nursing Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100225000779 AL Part A Provider - Skilled Nursing Facility 5193700797 Practice locations: Ashland, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417003245. Details of each certification follow.

Skilled nursing facility certification: CCN 015124

Legal name
CLAY COUNTY HEALTHCARE AUTHORITY
Doing business as
CLAY COUNTY NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1974
Last certification
Mar 16, 2022
Beds
83
Ownership / control type
Other Nonprofit
Organization structure
CorporationNon-profit
Enrollment address
83825 Highway 9
Ashland, AL 36251-7981
Nursing home name
CLAY COUNTY NURSING HOME

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Clay County Nursing HomeCCN 015124 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Dec 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8370.6 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2190057Clay County Nursing Home83825 Highway 9, Ashland, AL 36251Certificate of waiverAug 9, 2026

National Provider Directory

National Provider Directory
Tax ID family
Clay County Hosp6 organizations share this tax ID, including this one
Part of
Clay County Hosp

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Timothy C Jarmon Individual W-2 Managing Employee Dec 8, 2009
Bobby Crenshaw Individual Corporate Director Dec 8, 2009
Cynthia a Crawford Individual W-2 Managing Employee Dec 8, 2009
Donna C Glenn Individual W-2 Managing Employee Dec 8, 2009
Mary S Williams Individual W-2 Managing Employee Dec 8, 2009
Belever J Perry Individual W-2 Managing Employee Dec 8, 2009
Linda T Smith Individual W-2 Managing Employee Dec 8, 2009
Kerry Tomlin Individual W-2 Managing Employee Dec 8, 2009
Kattie Wilkinson Individual W-2 Managing EmployeeDirector Payroll Oct 23, 2011
Clay County Healthcare Authority Organization, Ashland, AL Non-profit Operational/Managerial Control Jan 1, 1966 100%
Gerald Burdette Individual Corporate Director Dec 8, 2009
Larry Fetner Individual Corporate Director Dec 8, 2009
Julia G Carpenter Individual W-2 Managing Employee Dec 8, 2009
Kathy B Jackson Individual W-2 Managing Employee Dec 8, 2009
Ben Wood Individual Corporate Director Dec 8, 2009
Lennie Luker Individual W-2 Managing Employee Aug 3, 2009
Robin Graben Individual W-2 Managing EmployeeDirector Purchasing Nov 6, 2011
David R Miller Individual W-2 Managing Employee Dec 8, 2009
Dwight Harris Individual Corporate Director Dec 8, 2009
Stephen Young Individual Operational/Managerial ControlCeo May 1, 2021

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clay County Hospital Home Care, LLCAshland, AL, CCN 017097 Home health agency 5% Or Greater Direct Ownership Interest (10%) Nov 1, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1417003245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1270",
            "city": "ASHLAND",
            "state": "AL",
            "postal_code": "362511270",
            "telephone_number": "256-354-1141",
            "fax_number": "256-354-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83825 HIGHWAY 9",
            "city": "ASHLAND",
            "state": "AL",
            "postal_code": "362511270",
            "telephone_number": "256-354-1141",
            "fax_number": "256-354-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY HEALTHCARE AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAY COUNTY HEALTHCARE AUTHORITY",
        "enumeration_date": "2007-01-26",
        "last_updated": "2023-10-19",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-354-2131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "N1401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "01505",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "475333OS",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay County Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clay County Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, AL

Sources for this page

Verify at the official NPI Registry.